Interesting Article on Chronic Pain

When people have similar injuries, why do some end up with chronic pain while others recover and are pain free? The first longitudinal brain imaging study to track participants with a new back injury has found the chronic pain is all in their heads -- quite literally.
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A new Northwestern Medicine study shows for the first time that chronic pain develops the more two sections of the brain -- related to emotional and motivational behavior -- talk to each other. The more they communicate, the greater the chance a patient will develop chronic pain.
The finding provides a new direction for developing therapies to treat intractable pain, which affects 30 to 40 million adults in the United States.
Researchers were able to predict, with 85 percent accuracy at the beginning of the study, which participants would go on to develop chronic pain based on the level of interaction between the frontal cortex and the nucleus accumbens.
The study is published in the journal Nature Neuroscience.
"For the first time we can explain why people who may have the exact same initial pain either go on to recover or develop chronic pain," said A. Vania Apakarian, senior author of the paper and professor of physiology at Northwestern University Feinberg School of Medicine.
"The injury by itself is not enough to explain the ongoing pain. It has to do with the injury combined with the state of the brain. This finding is the culmination of 10 years of our research."
The more emotionally the brain reacts to the initial injury, the more likely the pain will persist after the injury has healed. "It may be that these sections of the brain are more excited to begin with in certain individuals, or there may be genetic and environmental influences that predispose these brain regions to interact at an excitable level," Apkarian said.
The nucleus accumbens is an important center for teaching the rest of the brain how to evaluate and react to the outside world, Apkarian noted, and this brain region may use the pain signal to teach the rest of the brain to develop chronic pain.
"Now we hope to develop new therapies for treatment based on this finding," Apkarian added.
Chronic pain participants in the study also lost gray matter density, which is likely linked to fewer synaptic connections or neuronal and glial shrinkage, Apkarian said. Brain synapses are essential for communication between neurons.
"Chronic pain is one of the most expensive health care conditions in the U. S. yet there still is not a scientifically validated therapy for this condition," Apkarian said. Chronic pain costs an estimated $600 billion a year, according to a 2011 National Academy of Sciences report. Back pain is the most prevalent chronic pain condition.
A total of 40 participants who had an episode of back pain that lasted four to 16 weeks -- but with no prior history of back pain -- were studied. All subjects were diagnosed with back pain by a clinician. Brain scans were conducted on each participant at study entry and for three more visits during one year.
Other Northwestern authors on the paper include lead author Marwan N. Baliki, Bogdan Petre, Souraya Torbey, Kristina M. Herrmann, Lejian Huang and Thomas J. Schnitzer.
The study was funded by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health grant NS35115.

 

Scorsese nice to see you here contributing some powerful information for us to learn by
im not sure what happened to the 40 patients at the end of the study
-A total of 40 participants who had an episode of back pain that lasted four to 16 weeks -- but with no prior history of back pain -- were studied. All subjects were diagnosed with back pain by a clinician. Brain scans were conducted on each participant at study entry and for three more visits during one year.-



I know they were diagnosed with back pain but how many went on to get better?

its interesting though the way the study talks about how the two parts of the brain communicate

now in my life I've seen lots of communication between my family members , friends and others
I've seen my sister for example get around other folks with chronic pain and as they discussed each others ailments
id actually watch my sis start to take on the very pain her friend or relative might be in
for example I've never seen my sister really in that much pain, but when she would go with me to
see other family members or friends and communicate about there pain- id literally watch her take on there symptoms of back pain, neck pain ,
shoulder pain and so forth- I really don't remember her getting around anyone in pain that she wouldn't in some form or fashion take on their
symptoms-
shed be strong, up moving heavy chairs and much more while at her home-
but as soon as shed get around another person that was in pain shed instantly take on every symptom they had.
is this what the research is getting at or could you tell me more about the study, im very interested
wisdom is the principle thing and I want all I can get
thank you in advance Scorsese, looks like your onto something very interesting

 

This seems to be the central sentence:

I'd always thought my problem had to do with not recognizing/feeling my emotions but this is saying that my emotions got channeled into the injury.

Does anyone have any thoughts about what this might mean in terms of treatment?

 

like all trauma, you recondition yourself and new neuro pathways grow -
you re-heal through calmness, and meditation
learning the 12 reminders and knowledge penicillin galore

 

It is all a symptoms-emotions cycle. I think Luke is quite right about what is the central sentence. This cycle can be kick-started by initial pain from an injury or emotions from an event or situation, now or in the past, consciously or subconsciously. How someone reacts to entering this cycle determines whether you'll get stuck in it or not. Any emotions of worry, anger, fear that you have about physical symptoms or emotions* add to their stickiness. Reconditioning yourself on how you react to physical symptoms and emotions is key as Eric states. Accept (don't repress!) and surf any symptoms or emotions, recondition yourself by positive talk and in time you'll get better at not getting wound up about it which makes the stickiness slowly dissolve...

*emotions about emotions? Yes, for example I feel depressed and become anxious about it. Or I feel sad and become angry about it. etc. etc.

So Luke, recognizing and feeling your emotions is good in my opinion, responding calmly to physical symptoms and emotions that visit you is what we have to learn.
Hope it all makes sense, but just like yourself I am still learning too Comments are welcome.

About the copying of symptoms... how about this... we are all programmed to mirror emotions others have, this enables us to show compassion or symphatize. So, if someone is sad, the person who is compassionate also becomes sad. When we add a certain symptom to the mix, it is all too easy to, consciously or subconsciously, focus on any micro-sign of that symptom in ourselves, especially when anxiety is at play... the self-reinforcing cycle starts... I think you can conclude that there is something we can call over-compassion.... again, comments welcome

 

This study seems to furnish additional confirmation to what Howard Schubiner says about the brain chemistry behind the onset of chronic pain. Nothing new really, but it does seem to build on what people have been saying for a long, long time already about the role of the prefrontal cortex in regulating emotions.



Anyone on the Forum think they want to take a stab at reconciling what Dr Schubiner says with the findings of this new study?

 

I've looked at those twelve reminders so many times. I think they are helpful and important but I'm not sure that looking at them alone has helped me. It's more that they help me choose which activities I want to focus on.

 

This helped me understand how the id and super ego generated tms Bruce, it was really the best teaching ive seen on it

 

I was just wondering Eric how what Dr Schubiner has to say in the video about psychological tension being generated by the conflict between the ego/superego and the id and the interaction between the frontal cortex and the nucleus accumbens described in the Northwestern study? Sounds like what Dr Schubiner is focusing on is the interaction between the prefrontal cortex and the amygdela, which seems to be a repository of emotions in the paleomammalian brain.

 

This particular video along with SteveO's book " The Great Pain Deception" were the sources that made me understand the psychological conflict that exists in our unconscious mind ( the divided mind). It is amazing how happiness could activate one part of the brain and deactivate the part that holds fear. This is where the concept of HAPPINESS FIRST AND TMS HEALING WILL FOLLOW NATURALLY WITHOUT AWARENESS comes in. I have moved to a new level of healing!!

 

Eric)- it sounds to me BruceMC like their focus on the pain is a factor in them keeping the pain- it also sounds like the grey matter issue is due to a lack of exercise and optimism so to sum it up I think they know if they studied a persons background and found out that they really never get over and pain from accidents- like someone that broke a tailbone ten years prior and they still talking about the pain ten years later it wouldn't be hard to know that person is going to develop chronic pain or for that issue folks that don't have optimism or never exercise could be an indicator that they will develop chronic pain- now maybe I might have looked at it wrong but if you ask me in conjunction with Dr, Shubiners teaching that the id is hurting and the mom or dad in the super-ego is trying to sooth the id and the ego itself is perplexed, the essence of knowing how someone can develop chronic pain- presto instant grits-I do think optimism is equal to exercise and exercise is equal to optimism when it comes to the grey matter issue

Northwestern study)- The nucleus accumbens is an important center for teaching the rest of the brain how to evaluate and react to the outside world, Apkarian noted, and this brain region may use the pain signal to teach the rest of the brain to develop chronic pain.

 

This is awesome Stock Trader, I came to the same conclusion, you most defiantly are on the road to recovery
man you got it going strong, stay course -cant wait to hear that success story- keep the patience it will come
you really got some good thoughts that are feeding your healing reservoir.

 

I agree Endless luke, I totally agree

 

It sounds like what you're saying, Eric, is that chronic pain is a "learned behavior" based on personality traits and early childhood experience. All the brain science shows is WHAT has happened, but not exactly WHY. The WHAT is neurochemical but the WHY is ultimately psychological and based on an individual's social environment and his/her reaction to it. In other words, if someone has obsessive-compulsive personality traits, is social isolated so they focus on the pain, and never ever exercise or do something physical that gets them out of their protective "shell", then they're much more likely to develop chronic pain after some accident or mishap.

 

you said it perfect BruceMC-